Aches and pains are nothing new to firefighters–we all get them. Old or young, in shape or not, they are just a part of our daily lives. For the most part, though, these little irritants disappear as quickly as they appear, leaving us no worse for wear. For Firefighter/Paramedic Daniel Lawless of the LAFD, however, one of these aches came but had no intention of leaving.

Daniel explained that the symptoms began as a light ache in one of his testicles. At first, he dismissed the discomfort as nothing, thinking maybe he had somehow unknowingly injured himself. He made an appointment with his doctor, which was quickly followed up by an ultra sound of the area. As he drove home from the procedure, his phone rang. It was his doctor requesting he make a follow-up appointment with a urologist as soon as possible. Hearing the urgency in the doctor’s voice, Daniel made the appointment and soon discovered it was testicular cancer.

Daniel is not alone with this disease. Dr. Kevin Chan of the City of Hope writes, “It is well documented that firefighters are at a higher risk of cancer than the general public. In fact, according to the Journal of Occupational and Environmental Medicine, firefighters were twice as likely to develop testicular cancer than the average American male. On a daily basis, firefighters are exposed to many potentially hazardous substances in the performance of their duties. These include, but are not limited to, diesel engine exhaust, soot, benzene, chloroform, styrene, and formaldehyde which may be inhaled or absorbed through the skin. This suggests that besides wearing their breathing apparatus during firefighting activities and a protected mask during overhaul situations, firefighters should also be paying close attention to assure they are wearing clean protective gear. Simply put, firefighters should wash their turnouts thoroughly after fighting a fire.”

“Simply put, firefighters should wash their turnouts thoroughly after fighting a fire”

Gold Lee, Esq., and his law firm has a long history of successfully representing first responders in worker compensations issues. He states, “Testicular cancer is just one of the many cancers under which the presumption applies. A presumption is a “legal fiction”, a deviation from the normal rules that would otherwise apply to an injured who has the burden of proof to show he/she got injured in the form and manner alleged. Presumptions shift this legal burden from the injured worker onto the defendant (city/employer) who must now prove why the injury is non-industrial. This is known as rebutting the presumption.”

“Presumptions shift this legal burden from the injured worker onto the defendant (city/employer)”

Although testicular cancer is less common compared to other forms of cancer, it is still the most common form of cancer in young men. Luckily, it is still very curable if detected early, with nearly 95.1 percent of patients surviving five years or more according to the National Cancer Institute. In many cases testicular cancer is caught early because the patient notices the presence of a lump on one of their testicles. However, this is not the only sign of the disease. The following is a number of less obvious, but still important, signs and symptoms to watch out for.

A heavy feeling below the belt. Even if you don’t have a lump on your testicles, a heavy feeling in the lower region, including your testicles and abdomen, can signal trouble. In fact, this is actually one of the more common symptoms of testicular cancer and is likely due to extra fluid or enlarged lymph nodes.

An enlarged or shrinking testicle. Although it may not be on your daily list of things to do, a check of your testicles should be routinely performed to avoid missing any change in size. The changes occur when there is a hormonal imbalance caused by an increase in estrogen or a decrease in testosterone caused by a testicular tumor.

Swollen legs. Blood clots form due to the spread of the cancer into the lymph nodes. This, in turn, constricts the blood flow to the veins in your legs. Deep vein thrombosis may form, causing you pain and even difficulty breathing. If this occurs, contact your doctor as soon as possible. Do not delay care.

Breast growth or soreness in the area. This next sign or symptom you may cause you a little embarrassment to speak of, but you need to get over it because it may actually save your life. Some testicular tumors produce hormones that cause breast tenderness or growth of breast tissue which is called gynecomastia. Some tumors can secrete high levels of a hormone called human chorionic gonadotropin (HCG), which stimulates breast development. Tumors can also produce estrogen, which, along with spurring breast development, can also lower your sex drive.

Lower back pain and shortness of breath. Now back pain is no stranger to most firefighters, but back pain without a mechanical cause is something to question. Shortness of breath, however, is never a good sign cancer caused or not. Unfortunately, these two symptoms are possible signs that the cancer has left the testicle and spread, either to the back of the stomach or to the lungs.

If you experience any of these symptoms, you should make an appointment with your doctor immediately. Testicular cancer is usually a fast-growing cancer, so if you experience any of the signs and symptoms mentioned, it is extremely important to see your doctor to be checked. This is not a time to be shy. Be proactive with your health and examine your testicles on a regular basis. The best time to do this is in a warm shower, since the warm water can relax your scrotum and make it easier for you to find anything suspicious. Anything out of the ordinary — such as lumps or changes in size, shape, and consistency— should be brought to the attention of your doctor as soon as possible.

Firefighter/Paramedic Lawless was lucky. He had discovered the disease early and is doing well today, though he will be monitored for up to 10 more years to assure the cancer does not return.

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